Systems Changes to Maximize the Impact of Supportive Housing on Ending Homelessness

1. Systems Changes to Maximize the Impact of Supportive Housing on Ending Homelessness Matthew Doherty, Director of National Initiatives August 14, 2014

2. Roles of USICH • Coordinates the Federal response to homelessness • Maximizesthe effectiveness of 19 Federal agency partners • Sharesbest practices • Drives collaborative solutions

3. Opening Doors No one should experience homelessness No one should be without a safe, stable place to call home

4. Opening Doors • Finish the job of ending chronic homelessness by 2016 • Prevent and end homelessness among Veterans by 2015 • Prevent and end homelessness for families, youth, and children by 2020 • Set a path to ending all types of homelessness

5. Point-in-Time Count Progress -8% since 2010 -16% -24% -24%

6. Turning Sets of Programs into Efficient Systems

7. Critical Questions & Decisions Is the system reducing the number of people experiencing homelessness? Are resources targeted effectively to those with the greatest needs, including those who are unsheltered? Does the community have the right balance of interventions(permanent supportive housing, rapid re-housing, etc…) to respond to local needs?

8. Critical Questions & Decisions Is the system exiting people from homelessness to permanent housing quickly and using the right size of intervention based on their needs?  How can the community align resources and design its system most strategically? Do strong connections exist between the homeless response system and intake processes for mainstream services?

9. Five Key Strategies Use Data to Drive Results: Use data to measure system and program performance and inform resource allocation decisions Be Frugal – Target Wisely: Provide the right intervention at the right time to the right individual or family through a coordinated assessment system Be Smart – Use Evidence: Adopt Housing First practices to offer individuals and families experiencing homelessness immediate access to permanent affordable or supportive housing, without clinical prerequisites or other barriers

10. Five Key Strategies Expand the Pie Strategically: Use existing resources in smarter ways to help make clear case for new investments of Federal, State, local, and private sector resources to scale the practices and innovations that work Leverage Mainstream Resources: Engage mainstream systems and integrate those resources— housing, job training, child care, health care, etc …

11. Coordinated Systems Access to services:broad access in community, coordinated street outreach, integration with mainstream systems Assessment of individual/family situationand needs to right-size the intervention: prevention, diversion, admit to shelter Align housing interventions:prevention, rapid re-housing, affordable housing, and permanent supportive housing

12. Reorienting our Systems “In order to bend the curve, we must first abandon the line.” - Richard Cho, USICH blog at www.usich.gov

13. Systems Approach Rapid Placement into Permanent Housing with Low Barriers Alcohol or Drug Treatment Psychiatric Hospital Hospital Standardized Assessment & Prioritization Assertive Outreach & Engagement & Discharge Planning Shelter Jail or Prison Streets Engagement in & Provision of Supportive Services Linked to Health

14. Retooled System Design an approach that recognizes that people take many paths to assistance, and intake processes for mainstream systems (e.g., cash assistance, health care) can serve as front doors. Effective, assertive outreach is essential, especially for people who are unsheltered, since the system only works if people get connected. System design must reflect local community context, including HMIS, geography, and many other factors

15. Community-Level Actions Develop systems for aligning housing and services interventions based upon assessments Adopt Housing First approaches that reduce barriers to and streamline housing entry Provide supportive servicesthat place low demands on clients, but engage frequently Prioritize people experiencing chronic homelessness for PSH as part of coordinated assessment implementation

16. Prioritizing for PSH Shift away from: • Passive role of housing agencies and providers in identifying prospective tenants • First come, first served approach to allocating affordable and supportive housing

17. Prioritizing for PSH Shift towards: • Proactive, assertive outreach that identifies, engages, and rapidly connects people with the highest needs to permanent housing • Prioritization of people based on objective measures of need, vulnerability, and cost

18. Expectations Under HEARTH Covers the Continuum's of Care (CoC's) geographic area Is easily accessible by households seeking housing or services Is well-advertised Uses a comprehensive and standardized assessment tool Responds to local needs & conditions Covers at least all CoC& Emergency Solution Grant (ESG) programs

19. Engage Mainstream Systems Physical and behavioral health care systems Medicaid-funded services and Federally-Qualified Health Centers Workforce development system Benefits and income supports

20. Encouraging Key Strategies

21. Encouraging Key Strategies Use Data to Drive Results: Use data to measure system and program performance and inform resource allocation decisions Be Frugal – Target Wisely: Provide the right intervention at the right time to the right individual or family through a coordinated assessment system Be Smart – Use Evidence: Adopt Housing First practices to offer individuals and families experiencing homelessness immediate access to permanent affordable or supportive housing, without clinical prerequisites or other barriers

22. Encouraging Key Strategies Expand the Pie Strategically: Use existing resources in smarter ways to help make clear case for new investments of Federal, State, local, and private sector resources to scale the practices and innovations that work Leverage Mainstream Resources: Engage mainstream systems and integrate those resources— housing, job training, child care, health care, etc …

23. Listening to Communities: Input for Opening Doors Amendment

25. For more information: Matthew Doherty Director of National Initiatives matthew.doherty@usich.gov 202.754.1586 (Based in San Diego)